Active NPI
Michele Ann Roberts, P C
- Gerontology Nurse Practitioner
- Valley Park, MO
National Provider Identifier
1811044233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- Legal business name
- MICHELE ANN ROBERTS, P C
- Practice address
- 13612 Big Bend Rd
Valley Park, MO 63088-1447 - Phone
- (314) 578-2100
- Fax
- (636) 333-4510
- NPI assigned
- Jan 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michele A Roberts, CNP
- Title
- Owner
- Phone
- (314) 578-2100
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Gerontology Nurse Practitioner | 363LG0600X | Primary |
Addresses
Primary practice location
13612 Big Bend Rd
Valley Park, MO 63088-1447
Mailing address
PO Box 323
Ballwin, MO 63022-0323
Phone (314) 578-2100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 428953418 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
6209 Mid Rivers Mall Dr
Saint Peters, MO 63304
Phone (314) 487-7215
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Ballwin, MO
- NPI 1467451708
-
- Professional Counselor
- Valley Park, MO
- NPI 1003083791
-
- Gerontology Nurse Practitioner
- Saint Louis, MO
- NPI 1598423543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768694400000",
"number": "1811044233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 323",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630220323",
"telephone_number": "314-578-2100",
"fax_number": "636-333-4510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13612 BIG BEND RD",
"city": "VALLEY PARK",
"state": "MO",
"postal_code": "630881447",
"telephone_number": "314-578-2100",
"fax_number": "636-333-4510"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHELE ANN ROBERTS, P C",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-05",
"last_updated": "2026-01-18",
"certification_date": "2026-01-18",
"status": "A",
"authorized_official_last_name": "ROBERTS",
"authorized_official_first_name": "MICHELE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "314-578-2100",
"authorized_official_credential": "CNP"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "428953418",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Valley Park, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.